Although no large, randomized trials have directly compared outcomes between the two leading treatment options for patients with low-risk prostate cancer, historical comparisons have found no difference in overall survival between patients undergoing radical prostatectomy (RP) and external beam radiation therapy (EBRT). Therefore, treatment decisions are often based on side effects and quality of life, which is a very subjective and personal experience. This study used a questionnaire to look at long term health related quality of life (QOL).

The questionnaire was sent to all 1,775 patients who underwent RP or EBRT for prostate cancer at the researcher’s center. 72% of RP patients and 66% of EBRT patients responded. Rates of health issues were uniformly higher among patients who had EBRT, including diabetes (18% vs. 12%), heart attack (MI) (27% vs. 14%), and stroke (9% vs. 3%).

Patients who had RP had a small, but statistically significant improvement in QOL related to urinary irritation and bowel problems, but had significantly poorer QOL pertaining to urinary incontinence. Although both groups had poor sexuality QOL scores, RP patients were better.

The majority of prostate cancers are diagnosed at an early stage, with either RP or EBRT resulting in good control and survival rates. In comparison to those who received EBRT, patients who underwent RP in this study population had better bowel and sexual quality of life, but worse self-reported urinary morbidity.

Results from this study may provide patients with early stage prostate cancer a view of the QOL following EBRT or RP that might help them when deciding which treatment modality to pursue.

Partially funded by an unrestricted educational grant from Bristol-Myers Squibb.